肝功能实验综合指数的建立与临床应用

ESTABLISHMENT AND APPLICATION OF HYPOHEPATIA INDEX OF BLOOD TESTS

目的 :建立肝功能实验综合指数 ,探讨其在肝功能状态判定中的应用。方法 :利用微机从肝功能指标原始数据中分析计算并确立肝功能实验综合指数 (HypohepatiaIndexofBloodTests ,HIBT ,简称肝功指数 )以及与Child-Pugh肝功能分级的相关性。结果 :468例健康受试者肝功指数为 0 .64± 0 .1 2。 1 32 4例肝病病人HIBT为 9.75± 1 5 .2。两组结果经t检验有非常显著的差异 (P <0 .0 0 1 )。肝功指数的CUTOFF定为 1 .0时判定肝功能不全的灵敏度为 96 .9% ,特异性为 97.6 % ,阳性预示值 94.5 % ,阴性预示值 95 .8%。 1 0 8例肝功能Child -Pugh分值与HIBT显著相关 (r=0 .680 3 ,P <0 .0 1 )。 5例肝病患者动态HIBT值与病情进展基本一致。 1 2 347例本院病人肝功能指数阳性率为 47.7%。结论 :肝功能实验综合指数 -HIBT将常规反映肝细胞受损和肝脏残留功能状态多项检验指标的有机结合 ,比较直观地反映了肝脏的病理状态 。

Objective: To establish a new index which can more cmprehensively and quantitatively reflect the physiological and pathological state of liver. Methods: Hypohepatia index of blood tests(HIBT) was calculated from the primary data of ALT,AST,TBA,TBIL,and Alb through computer program.The correlation between HIBT and Child-Pugh scores was studied.Results: The mean HIBT of 468 healthy samples was 0.64 ± 0.12 and the mean HIBT of 1324 patients was 9.75±15.2( P<0.001). HIBT yielded a higher sensitivity( 96.9%) and specificity(97.6%) in diagnosing hypohepatia when 1.0 was set as CUT-OFF value expressed in ROC curve. And the predictive value of a positive result was 94.5%, the predictive value of a negative result was 95.8%. Child-Pugh scores of 108 example markedly correlated with HIBT ( r=0.6803,P<0.01).The dynamic HIBT of 5 patients was basically consistent with their state of illness. Conclusion: HIBT exactly reflects the pathologic state of testee' s liver. It is valuable in the diagnosis and treatment of liver diseases.